Breast Cancer Facts You Need to Know

Dr. Nancy Simpkins talks screenings, risk factors and prevention.

From Nancy: Each year, Breast Cancer Awareness Month allows us to reinforce the importance of screening. According to the American Cancer Society, breast cancer is the most common cancer in American women, aside from skin cancer. It is the second leading cause of cancer death among them after lung cancer.

With earlier detection and better treatments, death rates from breast cancer continue to drop.

If there’s no history of breast cancer in your family and you’ve had normal breast exams at your doctor, your baseline mammogram should be at age 40. If there’s a strong family history (your mom or sister has been diagnosed), then screening should begin earlier, as discussed with your doctor.

How to properly screen for breast cancer is currently under review by the American College of Radiology. There’s ongoing debate about whether dense breasts (with less fatty tissue) are more prone to breast cancer. In 2017, women who are found to have dense breast tissue on mammograms may be asked to return for an ultrasound or MRI to assess the breast tissue more closely.

Women under 40 should have yearly breast exams at their gynecologist or internist. If you find lumps on your own, talk to your doctor about your specific history and physical findings. For example, if your mother had breast cancer before menopause, did she have gene testing (BRCA 1 and BRCA 2)? Having a mom, sister or aunt with premenopausal breast cancer and/or is BRCA gene positive increases your chance of developing breast cancer by 10 percent over the general population. For this reason, we begin screening “high-risk” women earlier, usually with a first mammogram by age 35.

According to BreastCancer.org, genetics play a role in breast cancer. About 5-10% of breast cancers are genetically linked. The rest of breast cancers arise de novo (from the beginning), without a known cause.

Some risk factors include smoking, prolonged estrogen use, obesity, inactivity and having dense breasts. Knowing this, we all can “stack the odds in our favor” by not smoking, eating healthy and exercising. Hormone use is something that you must discuss with your doctor. Be sure that the benefit of taking long-term estrogen after age 50 outweighs the risks.

On your initial mammogram, on or before age 40 according to your doctor, you’ll find out your breast density. Your breasts are either normal density, heterogeneously dense or extremely dense. You have no control over this and it’s not based on your body size and weight.

For normal density, a mammogram is sufficient. For heterogeneously dense, an ultrasound will be added. For extremely dense, an MRI may be recommended.

Breast cancer is the number one concern of most women. We hear about more and more women being diagnosed and it is a scary thought to all of us. So what can we do to alleviate our
greatest fear?

Talk to an internist and ob-gyn doctor and ask them for a plan that will work for you.

What healthy measures can you take to prevent breast cancer?

What imaging studies are right for you?

Do you need to see a breast specialist?

If you come to the doctor armed with your questions, you’ll overcome the anxiety that breast cancer presents to most women.